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Common Questions About Cancer

Many people have certain beliefs or attitudes about cancer that are untrue or misleading. If patients don't correct these beliefs, they can interfere with their reactions to the diagnosis and its treatment. We have compiled a list of common questions about cancer in the hope of dispelling these myths. These questions are divided into three categories: questions about cancer, questions about treatment, and questions about how to cope with the illness.

Questions About Cancer

Is cancer contagious?

There is no way that you can "catch" cancer from someone else or give it to others. This idea probably developed because of the fears associated with the disease, especially years ago, when so little could be done for the illness and people avoided contact with patients because the disease was so frightening to them. While there is absolutely no scientific evidence that you can catch cancer from another person, some patients even today say that people have avoided them after their diagnosis. Whether this is because of the fear of contagion or because they may not know what to say to someone with a new diagnosis, the end result can be the same -- the patient feels isolated. If you sense this happening, the burden often falls on the person with cancer to reassure people that cancer is not contagious.

Can cancer be caused by an injury?

Injuries such as bruises, cuts, or broken bones cannot cause cancer. This idea is popular because a person may suffer an injury, see a doctor, and, coincidentally, a tumor, which has been there for awhile, is discovered. A fall or an injury to the breast cannot cause breast cancer. An athlete with a bruise or swelling in the leg will not develop a bone tumor.

Cancer is a very complex disease, arising from a combination of many different factors. If there were one single cause of cancer, such as an injury, the cure would have been discovered long ago. An exception to this is lung cancer: certain kinds can be directly linked to smoking. Even with lung cancer, however, there is no one simple cause because not all smokers will develop lung cancer, and some people who have never smoked may develop the disease. Cancer is caused by many factors, and there is no one single cause to explain it.

Are all cancers inherited?

Many people believe that cancer runs in families, and that if one family member has it, others are likely to develop the disease. It is true that the risk factors for certain types of cancers (breast, colon, some melanomas) tend to be inherited. In these situations, the risk may be increased by other factors, such as poor diet, smoking, hormonal influences, or occupational exposure. These factors, combined with a family history of melanoma or colon or breast cancer can put certain people at a slightly higher risk of developing a cancer.

If you have a family history characterized by people with different kinds of cancer (an uncle with lung cancer, a grandparent with leukemia), you are no more likely than the general population to develop a cancer. Likewise, if you have been diagnosed with bladder cancer, prostate cancer, or a brain tumor, your children cannot "inherit" this type of cancer from you. Occasionally you will read about "cancer families" in which there are unusually high numbers of people who have the disease. These families are being intensively studied by the National Cancer Institute, but so far, definite conclusions have not been reached about this very small group. This phenomenon is still not understood by cancer researchers and is in no way viewed as proof that cancer is an inherited disease.

Is cancer a disease of the elderly?

Many people think they don't have to worry about developing cancer until they are older. But only about 50 percent of all cancers occur in people over 65. People under the age of 40 often think they have no chance of getting cancer and delay seeing their doctor if they have a worrisome symptom. Some cancers, like testicular cancer or Hodgkin's disease, are examples of cancers more likely to occur in younger people. These facts are not meant to alarm you -- only to make you aware that cancer can occur at any age.

Does personality or stress cause cancer?

Some researchers have been interested in the question of the relationship of an individual's personality and the development of cancer. For instance, several studies have concluded that people who have difficulty expressing anger are more likely to develop cancer. These studies have serious flaws in the way they were conducted, and most cancer specialists do not believe any link exists between personality and cancer. Cancer is too complex a disease to be explained by a single cause. There is no scientific evidence that a person's personality could cause the development of cancer.

The same may be said about the idea that people under severe stress are more likely to develop cancer because they were emotionally upset for a long period of time. This area of research, however, deserves further study. There does seem to be some association between severe stress, combined with other physical and genetic factors, which may contribute to heart disease, ulcers, and other ailments. Scientists continue to study the relationship between the onset of these diseases and high levels of stress. This is a complex question, but so far, there is no scientific evidence that proves that stress can cause cancer. There is also no evidence that if you are upset about having cancer you can cause your cancer to spread faster, or that being upset will interfere with the effectiveness of your treatment.

Is cancer always painful?

The myth that cancer is always painful is associated with people's fear of the disease. Some cancers cause no physical pain at all. Some patients who die from cancer may experience mild to severe pain. The good news, however, is that with recent advances in pain management, pain can be prevented or controlled. We can now reassure the vast majority of patients with extensive disease that they will remain comfortable. If patients suffer from severe pain, they or their families must be aggressive in seeking the consultation of a pain specialist. (See PAIN CONTROL)

The other myth about pain is that it is an early symptom of cancer. This myth is responsible for delays in diagnosis because many people think that if changes in their bodies are not painful, they don't need to worry. Very few cancers in their early stages produce pain, so people should not wait until something hurts before they see their doctor. Early detection offers our best opportunity for cure or long-term control.

Does cancer mean certain death?

No. In fact, about half of all newly diagnosed people with cancer will be cured by currently available treatment. Indeed, today hundreds of thousands of people have already been cured and are leading normal lives.

Even those people who are not cured may still carry on with little change in their lives. In this case, cancer for these people is really a chronic illness, with similarities to diabetes, for example. All of us know people with diabetes who, if they watch their diets and take their medication, lead normal lives.

One of the major concerns of people who have been diagnosed with cancer is whether the disease can be cured with treatment. Some ask their doctors to predict the future even before treatment has begun. Most doctors are uncomfortable about this because no one knows how one person will respond to treatment. Because of rapid changes in cancer treatment, survival rates for some cancers (certain leukemias, testicular cancer, and Hodgkin's disease, for example) have changed dramatically and today can be cured. In the past, many patients with these types of cancer were not cured. This shows that it's not a good idea to rely on history to predict how a person diagnosed with cancer today will respond to treatment.

Another misconception is that all cancers are the same. "Cancer is cancer, and it's always bad!" is a common belief. There are at least 100 kinds of cancer, and treatment and survival rates for each kind are very different. Remember that curing a patient depends upon the ability of the treatment to remove all the cancer cells in the person's body. If cure is not possible, the goal will be to control the illness, meaning to stop or slow down its spread. Cancer statistics apply to large groups of people and they have little meaning for one individual.

Because it may be difficult for your doctor to tell you for certain that all the cancer cells have been removed through treatment, he or she will ask that you make follow-up visits for a period of time. This uncertainty about the success of treatment may make you feel uneasy, but the purpose of these visits is that a cancer that recurs (comes back) can be treated and controlled. Even if your doctor tells you that your cancer has spread, treatment may still arrest it. Always remember that treatment is available to all patients regardless of the type of cancer or its severity. The danger in believing that "cancer equals death" is that persons with cancer will be considered "dying" and beyond help. In fact, they are living with a treatable chronic illness. The focus must always be on how a person will live with cancer.





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